Intraoperative Imaging With a 3D C-Arm System After Zygomatico-Orbital Complex Fracture Reduction

Wilde, Frank; Lorenz, K; Ebner, Ann-Kathrin; Krauß, Oliver; Mascha, F.; Schramm, Alexander

doi:10.1016/j.joms.2012.10.031

Cited by 100 publications

(54 citation statements)

References 15 publications

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“…The reconstruction results may be controlled instantly and corrected immediately if needed. A beneficial finding that is also described in previous studies of intraoperative imaging [15,18,21,23].…”

Section: Interrater-agreementsupporting

confidence: 79%

“…Mostly CBCT is used, which has a poorer contrast than Medical CT scans. High-contrast structures as bone and radio-opaque reconstruction materials may be imaged comparable to Medical CT scans and therefore adequately assessed [23]. In the same study the 3D C-arm system is described as an effective tool for intraoperative evaluation of reduction in ZMC fractures.…”

Section: Interrater-agreementmentioning

confidence: 99%

“…Intraoperative MDCT (multidetector computed tomography) and CBCT (cone beam computed tomography) scans to confirm ideal reconstruction are described in the literature as effective [13][14][15][16][17][18][19][20][21][22][23][24].…”

Section: Introductionmentioning

confidence: 99%

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Influence of Mirrored Computed Tomograms on Decision-Making for Revising Surgically Treated Orbital Floor Fractures

Blumer

Gander

Gujer

et al. 2015

Journal of Oral and Maxillofacial Surgery

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PURPOSE This study evaluated whether intraoperative imaging with computer-assisted virtual reconstruction would be advantageous in reconstructions of orbital floor fractures. The surgeon's intention to revise a reconstructed primary orbital floor fracture by evaluating a postoperative mirrored computed tomographic (CT) scan was analyzed intraoperatively before wound closure, during inpatient hospitalization, and after hospitalization. The inter-rater agreement and the match of intention to revise and actual revision were analyzed. MATERIALS AND METHODS Fifty-one anonymized postoperative CT scans of patients with a unilateral orbital floor fracture were mirrored using software. These computer-assisted virtual reconstructions were consecutively examined by 4 examiners. Seven of these patients underwent a revision. In the first part, the inter-rater agreements for all 3 times were analyzed. In the second part, the examiners' intentions to revise were compared with the actual performed revisions. RESULTS The overall inter-rater agreements were 0.69 for the intraoperative phase, 0.55 for the in-hospital phase, and 0.39 for the post-hospital phase. The intraoperative inter-rater agreement for each examiner was 0.58 to 0.80. The Fleiss value for the in-hospital and post-hospital phases was lower. The comparison of the examiners' intention to revise and the actual revisions showed that 15 to 24 additional would have been revised. In contrast, 6 of 7 actual revisions would have been revised intraoperatively. The missed actual revision was the same case by all 4 examiners. The accordance of intention to revise with the actual revisions decreased during hospitalization and even more after hospitalization. This study showed strong agreement among examiners for revising anatomically incorrectly reduced orbital floor fractures intraoperatively by evaluating postoperative mirrored CT scans. During the in-hospital and post-hospital phases, the restraints against revision seemed to increase, thus leading to poorer interrater agreement. This analysis of postoperative CT scans with computer-assisted virtual reconstructions of the orbit would have led to considerably more revisions intraoperatively, but all actual revisions were detected except for 1 case. This case was the same for all 4 examiners. Operation time would have been prolonged in the additional revised cases, but a better anatomic reconstruction would have been achieved. Furthermore, the intraoperative result of the reconstruction would have been controlled instantly and corrected immediately, if needed. CONCLUSION This study showed that of 6 of 7 actual revisions, implant placement would have been revised intraoperatively by all 4 examiners, if intraoperative imaging with computer-assisted virtual reconstruction of the orbit would have been applied. Therefore, the authors suggest that intraoperative imaging with computer-assisted virtual reconstruction could be advantageous in the prevention of later revisions of orbital floor fractures. In this study, the t...

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Section: Interrater-agreementsupporting

confidence: 79%

Section: Interrater-agreementmentioning

confidence: 99%

See 1 more Smart Citation

Influence of Mirrored Computed Tomograms on Decision-Making for Revising Surgically Treated Orbital Floor Fractures

Blumer

Gander

Gujer

et al. 2015

Journal of Oral and Maxillofacial Surgery

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“…to monitor the effectiveness of parathyroid gland surgery in hyperthyroidism), and improvements in imaging technology and micro‐catheter design will broaden future applications in the management of malignant lesions . Intraoperative imaging for the repair of facial fractures provides immediate feedback to surgeons about inadequacies in fracture reduction and implant placement, leading to improved surgical outcomes . While CBCT technology is likely to gain more popularity in interventional and intraoperative imaging in the future, this will require improvement in image quality (e.g.…”

Section: Introductionmentioning

confidence: 99%

Application of three‐dimensional computed tomography in craniofacial clinical practice and research

Anderson

Yong

Surman

et al. 2014

Australian Dental Journal

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Following the invention of the first computed tomography (CT) scanner in the early 1970s, many innovations in threedimensional (3D) diagnostic imaging technology have occurred, leading to a wide range of applications in craniofacial clinical practice and research. Three-dimensional image analysis provides superior and more detailed information compared with conventional plain two-dimensional (2D) radiography, with the added benefit of 3D printing for preoperative treatment planning and regenerative therapy. Current state-of-the-art multidetector CT (MDCT), also known as medical CT, has an important role in the diagnosis and management of craniofacial injuries and pathology. Three-dimensional cone beam CT (CBCT), pioneered in the 1990s, is gaining increasing popularity in dental and craniofacial clinical practice because of its faster image acquisition at a lower radiation dose, but sound guidelines are needed to ensure its optimal clinical use. Recent innovations in micro-computed tomography (micro-CT) have revolutionized craniofacial biology research by enabling higher resolution scanning of teeth beyond the capabilities of MDCT and CBCT, presenting new prospects for translational clinical research. Even after four decades of refinement, CT technology continues to advance and broaden the horizons of craniofacial clinical practice and phenomics research.Keywords: Multidetector CT, cone beam CT, micro-CT, dentistry, teeth.Abbreviations and acronyms: 2D = two-dimensional; 3D = three-dimensional; CBCT = cone beam computed tomography; CLP = cleft lip and palate; CT = computed tomography; DEJ = dentino-enamel junction; FGFR2 = fibroblast growth factor receptor 2; micro-CT = micro-computed tomography; MDCT = multidetector computed tomography; MRI = magnetic resonance imaging; nano-CT = nanocomputed tomography; OPG = orthopantomograph; PET = positron emission tomography.

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“…13 Postoperative complications and facial contours were evaluated during the fellow-up. 14 The functional recovery was evaluated by the difference between the pre-operative 15 maximum interincisal mouth-opening and that of the final follow-up. 16 Results Twenty-three patients were included in the case series.…”

mentioning

confidence: 99%

Applications of Computer-Assisted Navigation for the Minimally Invasive Reduction of Isolated Zygomatic Arch Fractures

Zhi

Yang

2015

Journal of Oral and Maxillofacial Surgery

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Intraoperative Imaging With a 3D C-Arm System After Zygomatico-Orbital Complex Fracture Reduction

Cited by 100 publications

References 15 publications

Influence of Mirrored Computed Tomograms on Decision-Making for Revising Surgically Treated Orbital Floor Fractures

Influence of Mirrored Computed Tomograms on Decision-Making for Revising Surgically Treated Orbital Floor Fractures

Application of three‐dimensional computed tomography in craniofacial clinical practice and research

Applications of Computer-Assisted Navigation for the Minimally Invasive Reduction of Isolated Zygomatic Arch Fractures

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